A clinical and immunologic study of employees in a facility manufacturing trimellitic anhydride.

We conducted a 1-year cross-sectional survey of 474 employees of a large chemical manufacturing complex to relate trimellitic anhydride (TMA) exposure to serologic and clinical outcomes. In 1988-1989, employees were evaluated by history and immunologic assay of total (T) and IgE antibody to trimellityl human serum albumin (TM-HSA). All employees were assigned to a TMA exposure class, from 1 (highest) to 5 (lowest), by an industrial hygienist, independent of the clinical and immunological data. Thirty-two (6.8%) of 474 employees had a TMA immunologic syndrome, 31.6% with an irritant response and 61.6% with no symptoms. Twelve had asthma/rhinitis, 10 had the late respiratory systemic syndrome (LRSS), four had late onset asthma, one had late onset arthralgia, and five had a distant history of LRSS. Included in this survey of the entire work force were 321 new enrollees, who had not joined the previous (1976 to 1988) voluntary surveillance program. Only four (1.3%) of the new enrollee group had a TMA immunologic syndrome. Among new enrollees, there were lower mean total and IgE serum antibody levels in lower exposure classes and a higher percentage with elevated antibody levels in high exposure classes (for T, x2 = 17.5, p = .0016; for IgE, x2 = 76.7, p less than .0001). In the new enrollee population, demographic variables of age, sex, date of hire, and smoking status were examined related to antibody levels. Only current or former smoking was related to elevated total antibody levels.

A twelve-year clinical and immunologic evaluation of workers involved in the manufacture of trimellitic anhydride (TMA).

The spectrum of immunologic lung disease occurring in a population of 196 workers involved in the manufacture of trimellitic anhydride (TMA) was assessed from January 1976 through December 1987. Workers were evaluated clinically by history, blood counts and chemistries, chest x-ray, and pulmonary function studies. Immunologic tests included skin testing with trimellityl-human serum albumin (TM-HSA) and assay of total antibody (TA) and of IgE antibody binding of 125I-TM-HSA. Seventeen workers had IgE-mediated asthma/rhinitis with a positive prick test to TM-HSA and IgE antibody of 0.8-57 ng of TM-HSA bound/ml. Seven workers had a late respiratory systemic syndrome with TA from 760-56,000 ng of TM-HSA bound/ml. Four had both syndromes. Three had late onset asthma with TA of 3,700-10,000 and trace levels of IgE to TM-HSA. One had marked arthralgia and myalgia occurring hours after TMA exposure, without respiratory symptoms, with an elevated TA level of 24,000. Of 46 workers reporting no symptoms, 8% had low TA levels, while 16% of 113 with irritant symptoms had low TA levels. There was a reduction in the number of workers exhibiting an immunologic syndrome during 1982-1987-8% (7 of 85) compared to 23% (26 of 111) during 1976-1981--in spite of increased TMA production. This paralleled environmental control and worker education efforts. Cooperative research by an academic Allergy-Immunology program and industry has defined TMA clinical syndromes and provided methods of immunologic monitoring, resulting in a reduction in new cases in spite of increased production of TMA.

Mortality in a recent oil refinery cohort.

A retrospective cohort mortality study of 10,763 Amoco Corporation oil refinery workers employed between 1970 and 1980 showed low overall mortality; the standardized mortality ratio for all causes of death was 73 for white males and 68 for black males. White male mortality was examined by several exposure classifications devised for group cohort members by potential for exposure to refinery processes and exposure to two components of petroleum (light aromatic hydrocarbons and heavy oils). Statistically significant elevations were found in various exposure groups for skin cancers, digestive system cancers, and benign neoplasms. Of these, skin cancer mortality appeared to increase with increasing exposure.

Health insurance claims of petrochemical company employees.

This paper describes a morbidity data base for epidemiologic studies which uses information from health insurance claims. Strengths of the data base include completeness and relatively low cost. A limitation is the length of time needed for all claims to be received and processed: rates generated using current information are lower than they will be after all claims are processed. Nevertheless, internal comparisons can presently be made using such rates. Examples illustrate differences in claims experience according to employees' smoking habits and according to kind of job.

Determining exposure categories for a refinery retrospective cohort mortality study.

This paper describes and compares two methods used to assign exposure categories to 10,766 petroleum refinery employees included in an epidemiological study. The first scheme grouped individuals into six organization (OR) job groups: Administrative, Maintenance, Operations, Laboratory, General and Other. This scheme used "most common administrative department," as determined by computerized job histories. For the second classification scheme, "most common job title" and "most common plant location" were used to group individuals in four ways (IH codes): 1)job type (administrative, maintenance, operations and unknown); 2) contact with refinery processes; 3) exposure to light aromatics; and 4) exposure to heavy oils. Exposure categories for the latter three were none, occasional, routine and unknown. Comparison of the two schemes showed that OR job groups developed from administrative job histories were sometimes useful in classifying employees according to refinery exposures. While OR job groups were acceptable for employees clearly in managerial, maintenance or operations positions, IH codes provided more precise exposure profiles for these three relatively homogeneous groups. For individuals in laboratory positions and those with vague or unspecified department codes (23% of this cohort), the IH classification codes were necessary to group employees by job and exposure.

Smoking habits of oil refinery employees.

Smoking habits of White male employees of a large oil company were analyzed. There were only slight differences in smoking habits between refinery and nonrefinery employees. Salaried employees, both at refineries and elsewhere, smoked much less than hourly employees.

Survey of reproductive events of wives of employees exposed to chlorinated dioxins.

To determine whether paternal exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) or other polychlorinated dioxins might be associated with adverse pregnancy outcomes, an interviewer-administered questionnaire survey was conducted among wives of Dow Michigan Division employees in the Midland, Michigan, area who had been potentially exposed to dioxins. A control group consisted of wives of employees who had no dioxins exposure and whose hire dates were comparable to those of the men in the exposed group. A total of 737 conceptions, which resulted in 637 live births and 10 stillbirths and spontaneous abortions, were identified as having paternal exposure; 2031 conceptions, resulting in 1785 live births and 246 stillbirths and spontaneous abortions, were identified as having no paternal exposure to any isomer of dioxin. Odds ratios were calculated for dependent variables consisting of spontaneous abortions, stillbirths, infant deaths and several categories of congenital malformations. Trend analysis was performed for duration-of-paternal-exposure of 12 months or less, or more than 12 months. Overall, no statistically significant associations were found between any exposure and pregnancy outcome, either before or after stratification by pertinent sets of up to nine covariables.

Serological study of amoebiasis and toxoplasmosis in the Malili area, South Sulawesi, Indonesia.

Results of a serology survey in September 1972 for Entamoeba histolytica and Toxoplasma gondii antibodies among 915 volunteers from the Malili area of South Sulawesi (Celebes), Indonesia are presented. Indirect hemagglutination antibody titers for amoebiasis were found in 22.7% of the sampled population while 9.5% demonstrated antibody titers greater than or equal to 1:128. The frequency distribution of antibody titers were similar by sex and age. There was no significant correlation between stool positivity and seropositivity. Indirect hemagglutination antibody titers for T. gondii were detected in 62% of the population sampled, and titers greater than or equal to 1:32 were demonstrated in 29% of the samples tested. The distribution of antibody titers was similar in males and females. In both sexes the prevalence of IHA antibody titer against T. gondii increased with age. There was no consistent association between altitude and prevalence of seropositive samples.